Is it Safe?
High Profile Cases Spur Questions
By Rhonda Mann
Beth Israel Deaconess Medical Center Staff
Erin is one of seven in her family to have weight loss surgery. So when former New England Patriot's defensive coach Charlie Weis took the stand in his medical malpractice trial three years ago, the Merrimack Valley mother followed the testimony closely.
"The case got so much attention because of who he is," says Erin, who asked her last name not be used. "For one negative story like this, there are at least 500 positive ones."
Weis had suffered life-threatening complications after undergoing gastric bypass surgery in June of 2002 at a Boston hospital. The case was declared a mistrial, but has stirred the debate over the risks associated with what is becoming a more popular obesity treatment.
"During the trial, we had many patients come in concerned about safety," says
Dr. Dan Jones, head of the
Bariatric Surgery Program at Beth Israel Deaconess Medical Center. "And I think that awareness is a good thing. A front page story can really drive home this is a serious decision and complications can happen to anyone."
According to the Department of Public Health, there were 2,654 weight loss procedures done in Massachusetts in 2005-that's up from 402 cases in 1998. While statistics show most people do well, there is a risk of complications such as infection and bleeding. Obese patients also often have other diseases like diabetes and hypertension, further heightening the risks of surgery. The Agency For Health Care Research and Quality reports about one in every 500 patients who undergo weight loss surgery nationally die as a result.
"Five years ago, the mortality rate was one in 100, so we've found a way to make it safer" says Dr. George Blackburn, an obesity expert at Beth Israel Deaconess Medical Center and vice chair of a statewide panel charged with setting guidelines to enhance weight loss surgery outcomes in Massachusetts.
report recommends weight loss surgery centers meet strict qualifications including the credentialing of surgeons, proper educating of patients about the risks, and screening and counseling provided by experts in psychology and nutrition. The report also suggests that the risk of medical errors is reduced when surgery is performed by doctors who have done more than 50 cases per year in properly equipped, high-volume weight loss centers.
In fact, a new
study by the Agency for Healthcare Research and Quality (AHRQ) found that nationally, the average rate of post-surgical and other complications in patient who have had bariatric surgery, declined 21 percent between 2002 and 2006, a result that is in part due to more experiences physicians performing the procedures.
"For the right patient, a well credentialed bariatric surgery program is a critical tool," Blackburn says. "For those who are severely obese, there is no alternative to surgery that actually has been found to be effective for long-term weight loss." Accredited bariatric surgery programs can be found through the
Surgical Review Corporation and the
American College of Surgeons.
Blackburn points out a
2004 analysis of 136 studies from the University of Minnesota which found weight loss surgery resolved other major diseases: sleep apnea (86 percent), diabetes (77 percent), and hypertension (62 percent). He says by getting off the weight and making patients healthier overall, surgery cuts the risk of death by 50-80 percent compared with non-surgical options.
"I looked at the risks of surgery, but for me, I felt I had a greater risk of having a heart attack because of my (excess) weight," says Erin who had tried many diets over a 20 year period but could never keep the pounds off.
Five of Erin's relatives had gastric bypass surgery similar to Weis. She says all have lost at least 100 pounds. Erin and another family member had a less invasive, laparoscopic banding weight loss procedure. Since having the surgery in December of 2005, Erin has lost 50 pounds.
"Some people think that even with the risks (surgery) is an easy way out," she says. "I have to go to the gym, eat healthy foods-it's a lot of work."
But she says for her, it was the right choice.
"I did it to be a healthier mother," she says.
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted January 2010